Abstract 14618: Fasting Glucose, NT-proBNP, Treatment With Glycoprotein IIb/IIIa Inhibitors, and Outcomes in Non-ST-Segment Elevation Acute Coronary Syndromes: An Analysis From EARLY ACS
Objective: Higher N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels have been linked to a more favorable glucometabolic profile. Little is known about the interaction of NT-proBNP and fasting glucose in non-ST-segment elevation acute coronary syndrome (NSTE ACS) or whether they could inform treatment decisions. We explored these questions using data from the EARLY ACS trial.
Methods: Overall, 2240 patients had fasting glucose levels and baseline NT-proBNP levels. Multivariable Cox models were used to assess the association of fasting glucose and NT-proBNP with a 96-hr composite of death, myocardial infarction (MI), recurrent ischemia, or thrombotic bailout; 30-d death or MI; and 1-yr mortality.
Findings: There was no significant difference between treatment groups (early vs delayed provisional eptifibatide) in NT-proBNP levels above or below the median (p=0.62) or fasting glucose levels (diabetic pts and non-diabetic pts with fasting glucose < or ≥126 mg/dL, p=0.50). In adjusted Cox models, neither NT-proBNP nor fasting glucose was associated with the 96-hr endpoint (Table). NT-proBNP was associated with 30-d death or MI and 1-yr mortality (Table), but fasting glucose was only associated with 1-yr death (Table). NT-proBNP х glucose interactions terms were nonsignificant in all models (Table). Increasing fasting glucose and NT-proBNP were associated with increased risk of 30-d death or MI in patients who received early eptifibatide vs delayed provisional use (p=0.029 and p=0.045, respectively).
Conclusion: In NSTE ACS, both admission NT-proBNP and fasting glucose levels were associated with 1-yr death, but there was no interaction between these parameters. Increasing levels of fasting glucose and NT-proBNP were associated with higher 30-d ischemic events among patients receiving early eptifibatide.
- © 2013 by American Heart Association, Inc.